Skip to main content

tv   Key Capitol Hill Hearings  CSPAN  October 30, 2013 3:00am-5:01am EDT

3:00 am
would not be enrolling in an exchange. >> there could be numbers in there. >> did you know how many have qualified employer-sponsored insurance, and therefore will not be eligible for the exchange? do you know how many of those 700,000 are young adults who might choose to stay on the parent plant? >> i do not. >> do know how many are undocumented aliens, and who might not be eligible to enroll in the exchange? >> if you are aware, we have a connection to the data hub to check for that. if they are not eligible, they do not complete the application. i do not go on to shop. >> of the 700,000, do you have any idea how many are just looking, and how many are trying to enroll? >> we actually look at the people who are shopping. and obviously the majority of the people completing applications of their -- are there to go through to shopping. >> there are media reports that say as many as 80% of that number are eligible for medicaid. is that number something you would dispute? >> i do not know how they would get that information. i frankly would have hoped -- >> eligible for medicaid. is that a number you'd dispute? >> i don't know where that media report is or how they'd get that information. >> if that's true, that's the only information we're getting, frankly, today. i, frankly, would have hoped for a little bit more from you, but if that's true, then less than 140,000 of these applicants are potentially enrollees in the exchange, and that's assuming
3:01 am
they don't have employer-provided coverage, can't stay on their parents plan, or otherwise ineligible in some other way. but that means you're likely to hit less than one-quarter of this october estimate of 194,620. how many people did you estimate would enroll between november 15th and december 15th, which we're two weeks off from that period? >> i don't have that in front of me. i'll be happy to get you that information. >> if you could get that to the committee, i'd certainly appreciate that. given the back-end systems aren't working and insurers have resorted to manually enrolling people one by one, i just think the system doesn't, literally, have the human resource capacity to manually enroll the numbers that are being projected here. i assume that many people are holding off, are the young and healthy. so the risk pools in these exchanges are not going to align
3:02 am
with the projections. so i think not only are we going to miss the 7 million enrollee targeted, it appears we're going to miss the demographic makeup, as well, and that's going to be very important to have a functioning system. if the demographics are wrong, and there aren't as many young people enrolling, what happens then? what happens to premiums? >> i think the premiums are locked down for 2014, so, obviously, the next six months of enrollment are critical, and i'll remind you that enrollment does occur until march 21st of 2014, and the massachusetts experience was very slow initially, then it started to ramp up over time. we expect the same type of projections. >> but it doesn't look like you're even meeting your own projections that you had prepared. >> i have not listed any information on enrollment. i think there's some assumptions you're making. >> well, i'm just referring to this associated press memo that i appreciate you're willing to
3:03 am
give to the committee, that said that half a million people would sign up by october 31st. and that they would enroll. but if we don't meet this demographic of 2.3 million young people, i mean, it's very clear that premiums would go through the roof, whether in the next few months or in the future, and if that's where we're headed, and it appears that we are, how will you provide relief to individual americans, who don't want or can't afford this insurance, and how do we prevent the premium spike in 2015 as insurers will readjust their prices to reflect the actual enrollee demographic? >> currently, if you look at the premiums for 2014, we did not see premium spikes. we actually saw a very competitive marketplace, in fact, we have over 200 issuers just in the federal exchange alone who have offered more than
3:04 am
3,000 plans at very competitive prices. so markets have as many as 54 plans in a market. we've also seen 25% new issuers in markets. so far, what we've seen is the absolute opposite of what you're suggesting. >> have you enrolled in the plan? >> i have employer-sponsored insurance, i would not be eligible for the plan. >> so you're not participating in obama care? >> i'm participating in employer-sponsored insurance, which 85% of the country does. >> so you have government insurance, so you're not -- have you gone on the site and tried to enroll or tried to shop for plans? >> i haven't gone on to shop for the plans. i went on and actually signed up for an account and see what it looked like and go through the application process, but did not sign up for coverage. i'm not eligible for coverage, nor did i shop. >> i just want to mention to you a letter that i received from my
3:05 am
district, and this man wrote me and said, "my wife has been recently informed by her insurance carrier that her health care policy does not come ply with the affordable care act. now we must purchase the same policy at an 18% increase to our premium. what happened to if you like your insurance you can keep it question?" what would you say to that individual? >> i would take him back to pre-affordable care act days, where, in fact, if you were in the individual market, you were living at a 50% churn. half the people in the individual market, prior to 2010, didn't stay on their policies. they were either kicked off for preexisting condition, they saw their premiums go up at least 20% a year, and there were no protections from them, and sometimes they were in plans that they thought were fine until they actually needed a hospitalization, then they found out it didn't cover hospitalization or it didn't cover cancer. so take them back to the fact that since 1986, health care
3:06 am
costs and coverage have been the number one issue for small businesses for the last 20 to 30 years, and we've been talking about it for the last 20 or 30 years. that's actually why i came into this job, is to try and deal with this issue. so now what i would say is this, now if, in fact, the issuer has decided to change the plan, didn't have to, plans were grandfathered in in 2010, if they didn't make significant changes in cost sharing and this sort of thing, they could keep the plans that they had. but some insurance companies have decided, and i think that's what you're referring to in your opening statement they want to offer new plans, and if they want to offer new plans, they have to have the requirements of the affordable care act, which are you have to offer the ten benefits, you can't judge people on preexisting, you cannot discriminate based on sex. there are lots of things required under the affordable care act that actually protect consumers, but these premium increases were going on long time prior to the affordable
3:07 am
care act, and, in fact, we've seen the most premium moderation in the last three years than we've seen probably in 15 or 20 years. so that's what i would say to them. i'd try to explain to them the real issues. >> well, the carrier told them that the plan didn't comply, but nothing you said had anything to do with how they can get their costs down. that's the problem we're seeing here. >> what i would tell that individual, if their carrier is telling them they are changing the plan and offering an increase, they would need to go take a look at what's available in their state and in their market, which is certainly something that's available to them through the exchange. >> yeah, at an 18% increase. all right. with that i'll recognize mr. levin. >> well, thank you. a warm welcome. the chairman talked about the website, and you said it's going to be fixed.
3:08 am
and i might say, if everybody would pitch in to make it work, the goals that have been set would be more readily met. that's what happened with the prescription drug program. we all pitched in to make it work. and it had major problems at the beginning, and instead of standing in the way, we said we didn't vote for it, let's make it work. and it began to work. if we all had the same spirit about aca, it would be more than helpful. but then the chairman asked you about the notices coming from the insurance companies, and i'd like to ask you about that. a gentleman from michigan who had an $800 blue cross plan got
3:09 am
this notice from michigan blue cross, went into the website with the help of navigators, and ended up with a blue cross silver atmo plan with tax credits, in that case, instead of $800 a month, it's $77 a month. and let me refer you to the interview on "meet the press" with the blue cross florida ceo. he was asked by david gregory, in florida, the oldest and largest health care plan provider, florida blue cross, confirmed it is cutting 300,000 policies. and this is what the chairman of blue cross of florida said, "we're not cutting people, and i quote, we're actually transitioning people. what we've been doing is informing folks that their plan doesn't meet the test of the essential health benefits. therefore, they have a choice of
3:10 am
many options that we make available through the exchange, and, in fact, with subsidy, many people will be getting better plans at a lesser cost." so this has become a matter of legitimate discussion, and i think all of us would appreciate your addressing it. >> sir, again, going back to prior to the affordable care act days, these individuals in a small group or individual market had no protections. they had no guarantees of coverage, and they were still being charged somewhere between 20% or more premium increases year over year. so they could be kicked out at any time for preexisting condition, sometimes they thought they had coverage when they did not, and when they went in and had a cancer diagnosis or cardiac diagnosis, maybe they found out they had a $5,000 hospital limit or certain disclaimers.
3:11 am
then, of course, there was always if you were diagnosed with asthma or high blood pressure or another chronic disease, you might not be able to get coverage at all. so that's what's different. that's the first part. the second part is, in 2010, we told issuers to try to give some transition time if they wanted to keep policies as they were currently defined, whether they were in a group market or individual market, they could. so some of them elected to do that. now some of them are moving to the new standards, and the standards under the affordable care act are pretty simple. you have to have the 80% mlr, so you can't be taking money more than the 20% to mark marketing/advertising profit. you had to meet the ten essential health benefits. you had to define co-pay, deductible, and diseases in clear, understandable terms, so people would know what they were buying. you had to have choices among plans, then there were folks in the individual market who when they go on to the site may
3:12 am
qualify for tax credits. some in some states may qualify for medicaid expansion, but this is not -- this problem existed long before the affordable care act. now folks are transitioning into the new standards of the affordable care act, which guarantee you can't be denied, you won't be kicked off of a policy because you develop a problem, you may be eligible for tax credits, depending on your income, so these are important protections that are now available through the affordable care act, and i think that's important. >> thank you. i yield back. >> all right. mr. johnson's recognized. >> thank you, mr. chairman. ms. tavenner, thank you for being here. you know, i've been hearing from folks back home who, rightfully so, are very serious about their concerns and fears about their health care. steven from plano tried to purchase insurance through the exchange, but ended up more
3:13 am
confused and frustrate tors, operators didn't have answers to his specific questions. they simply reiterated that anyone could sign up for the exchange, but he should wait until later that evening or the next day to apply, since the systems were having technical difficulty. worse, a single father and police officer in plano went to renew his 11-year-old daughter's plan. she has no medical problems, yet her premiums doubled. doubled. those are real stories of fathers, mothers, sons, and daughters, who have to live with the law that up to now has completely failed them. ms. tavenner, the administration delayed the employer mandate for one year. the treasury witness before the committee testified the reason the administration granted big business a one-year delay is, quote, employers and their representatives have requested transition relief for 2014
3:14 am
because of concerns about the difficulty or cost of complying with the employer mandate. secretary sebelius appeared before this committee and repeatedly said obama care was ready. it clearly wasn't. doesn't the failed launch indicate many individuals are going to have to at least have as much difficulty complying with the individual mandate as big business had with the employer mandate, yet from the announcement last night, you've only given individuals a six-week delay. cms announced 700,000 people had submitted applications for exchange coverage nationwide, but with all the challenges you have been facing, there are some serious questions about what these applicants know. cbs news reported, "the shop and browse feature is not giving
3:15 am
consumers a real picture. in some cases, people could end up paying double what they see on the website." so how many applicants applied based on the wrong premium information, do you know? >> the completed applications were done, the 700,000, these were individuals who completed applications and figured out if they were eligible for tax credit. i do not know where cbs news is getting their information about erroneous tax credits, so i can't address that. i will say that in the individual mandate issue, that folks can apply through march 31st. we have said publicly that we will have the website in good working order by the end of november. we have always predicted that folks would increase their interest in enrollment in december and again in march, so we believe we are in good shape to handle that.
3:16 am
>> well, if you've identified the problem and are taking steps to identify who received faulty price information, apologize and provide the right information, are you doing that now? >> yes, sir. if we've given people the wrong information, we will certainly krektd it, but i'm not sure what cbs news is referring to. >> i'd like to bring your attention to a story which ran last week in "mother jones" with the headline "how healthcare.gov could be hacked." let me just quote from the article, "security experts say the federal health insurance website is vulnerable to a common technique that hackers use to steal personal information." as you know, i'm chairman of social security subcommittee and one of my longstanding priorities has been to protect americans' social security numbers. so, for the record, is obama care website 100% safe from hackers who can steal americans' personal information, including
3:17 am
their social security numbers? yes or no? >> we follow all the standards to protect information, including social security numbers. >> are you trying to say yes? >> am i trying to say yes that we follow the standards to protect information? yes, sir. >> you know, folks are confused and scared. they've heard horror stories and are now experiencing them firsthand, how can they trust the federal government to not only fix the website, but more importantly, give them the assurance that their personal information will be safe and their health care will be affordable, that if they want to keep their current plan, they can do so. the problems don't stop at the technical failures of a website. the real problem stems from the colossal failure to deliver what this law promised the american people. thank you, mr. chairman. >> all right. thank you. mr. rangel is recognized. >> thank you so much, mr. chairman. and welcome to our distinguished committee.
3:18 am
you may wonder why the administration appears to be under such severe attack by some members of this committee, especially as it relates to our goal to provide health care for 30 million americans that can't afford or don't have access to it, but it should give you some small comfort to know historically the republican party always fought vigorously against these type of programs. i don't think that one republican voted for the social security act, even those old enough enjoy the benefits. >> that's not accurate. >> that's not accurate. >> we'll see, maybe one or two, i don't know. but they oppose medicare. i spoke with president johnson, and he shared with me at the ranch the people that had signed
3:19 am
off on medicare, and anyway, it's big government, even if it saved lives. who cares? you're against big government, so why should obama be spared the attack because he wants americans to be healthy and strong and productive? we have to be consistent, and you guys and ladies have been. what i don't understand is that people aren't born as republican and democrats, and there has to be somebody, regardless of party label, that has suffered the embarrassment and the pain of being denied an insurance policy because they've been sick before. the people who actually need health care the most are too high a risk for some of the insurance companies, and this body, republican and democrats, allow things like this to happen. when i was a kid, if my mother took three of us, three children, to see a doctor and we
3:20 am
weren't sick, they would think she's crazy, because you couldn't afford a doctor. now health care will provide you getting the type of treatment to avoid you being sick and having to lose your dignity and impersonal emergency rooms that provide the most expensive health care that we have. but republicans who have always been admired for being fiscal conservatives have certainly seen the price of health care, the lack of quality that we may have today, soar to become such a part of our national budget that in my opinion, it's a threat to our national security. because as prone as some of you are to enter into conflict with other countries, you need healthy young people to fight these wars. and health care is important
3:21 am
from birth, throughout one's life. so i don't know how you're going to explain when this program, which is destined to succeed, how politically you're going to explain your positions today. and since your entire political program is locked into hatred for the president and this program, it seems to me that we have to find other ways for us to politically combat each other, because i hate to see the day that there's no republican party, and i have to rely just on my party for justice and fair play. and so we have to come together some kind of way to see what's best for america. now you may not like this program, and it certainly has been disappointing as a start, but what i want to see more from this committee is how can we improve and get quality health care for all americans? this has to be a part of the
3:22 am
goal that all of you have, and you also have to recognize that when we're lucky enough to have public servants to work for the administration, democrat or republican, that they are servants the same way we are and they deserve some dignity, as well. and so for america, i hope and have every reason to believe, like social security, like medicare, that the goodness of the program will prevail, and if there's anything that we can do to help you, and there may be some republicans that will join with me, to make certain that we get rid of what is not working and make certain everyone has access to health care. i wish i could see the politics involved in this, because i am a partisan, but a stronger america means a stronger party, and that's what we all are here for.
3:23 am
and i just want to thank you for your dedication and for you to recognize that it's all political and we have to do our job and get on with it. thank you for your service. >> thank you. mr. brady's recognized. >> just a quick fact check on the blast from the past. republicans did support social security and medicare, and more recently, republicans were the ones that reformed medicare to add that important prescription drug benefit so we could have seniors lead healthier lives, stay out of hospitals, and enjoy their grandchildren more. what's become abundantly clear, the flaw is not the website, the flaw is the law itself. this is what happens, we inject 159 new federal agencies, bureaucracies, and commissions between you and your health care. and this was supposed to be the easy part. this wait until you see the government making decisions about patient care, about reimbursements and treatments for -- that you receive from your local doctor and hospital.
3:24 am
ms. tavenner, i have a great deal of respect for you, and i suspect many republicans do, yet the white house, secretary sebelius, you and your staff, made repeated claims to the american public and to congress that everything would be ready on time, everything was a go. none of that proved to be true. now we're told everything will be okay very soon. so why should the american people believe you now? >> congressman brady, i would go back to what has worked in the last three and a half years since the affordable care act was implemented. we have been able to make a difference in the lives of coverage of young people. we've been able -- >> but specifically on the website and the exchanges, why should the american people believe you now? you've had nearly four years to get it ready. now you're saying in four weeks more it will be great.
3:25 am
so what's different? why should anyone believe these claims? >> because i think we've identified two major problems. one had to do with the initial volume, and despite our best volume projections, we underestimated the volume, the interest in the site. >> you noted the volume isn't the same as the applicants and the enrollment, that you yourself visited the site, clearly, you weren't shopping for it. others did, as well. to chairman camp's point, the number of applicants, the number of enrollees apparently still not known, is pretty modest, wouldn't you agree? >> but i would tell you that the number of visitors to the site and the number of people interested in completing applications was larger than even our initial projections, and we worked our projections off of the 7 million number that chairman camp mentioned. we also worked it off our history with medicare part d. so we've added capacity to the system, and we've improved system performance.
3:26 am
so that's the first thing. the second thing is, we have found what i will call functional -- or glitches, as we call them in the public term, in the actual application itself, which we're repairing. and that is the gradual improvements that you will see over the next four weeks, and that's why i'm confident about the end of november. >> well, can i tell you, my constituents are frightened. like millions of americans, they are now being forced out of the health care plan that they like. the clock is ticking on a website that's broken. their health care isn't a glitch, it's what they depend upon, so, you know, you've been described as a quarterback of the obama care rollout. i'm sure that's not the term you chose for yourself, but can you guarantee no american will experience a gap in their health care? >> so, what i can guarantee is, we have a system that's working. we're going to improve the speed of that system -- >> excuse me?
3:27 am
>> yes? >> you're saying the system right now is working? >> i'm saying it's working, it's just not working at the speed that we want and at the success rate that we want, and those are the things we are working on. we also have alternative methods for folks. they can use the call center, use paper applications, then we have in-person assistance available in each available in state. we can reach out to each individual and help them select the plan and enroll. yes, sir. >> to my point, this is not supposed to be fixed until november 1st. people have just two weeks to apply, enroll, be confirmed. so what happens on january 1st? when they have an illness, need patient care, have not heard back from the government. what do they do then? >> they have until march 31st to enroll. >> no. their plan has been canceled. >> you're talking about people
3:28 am
who -- >> again, i'm just trying to -- what my constituents want to know, what happens? >> the individuals who receive notices from their issuers is a different situation. they can certainly, obviously, sign up, transfer as we talked about earlier with blue cross of florida or they can go on the exchange or call the call center. >> my point is, it's been canceled. they don't have health care. they try to get on the website unsuccessfully. they don't know if they're enrolled. it's january 1st. they are facing a gap in coverage. what do you tell them? >> they can call the call center today and we will help them. we can help them through the call center. we have people in their individual markets that can help them in person. so there are more methods than just the website. that's important. >> i think what's become clear, as well. obama care is not ready.
3:29 am
yes is why don't we make it volunteer? give americans a choice so they are not forced into this health care they don't want. yield back. >> mr. mcdermott is recognized. >> the vote coming out of this committee was on party line vote. there were no republicans who voted for it when it left this committee. >> will the gentleman yield? >> or there were 81 finally voted for it. there is none left in the congress. >> 84% of the republicans voted for the social security act 77 years ago. i'm glad we are debating current events here. >> with the way my republican colleagues have been fretting over the success of the affordable care act exchanges, you never know they spent $24 billion shutting down the country to get rid of it.
3:30 am
suddenly they seem desperate to see a bill they didn't want. the exchanges are terrible and not enough people can enroll. this is one of the biggest reforms our country ever made and we are only four weeks into it. medicare wasn't built in a day. part d didn't roll out with snags along the way. as others mentioned, many of the republicans who are now calling for blood over this rollout were begging for patience on part d. the kinks of that rollout were easily brushed off by many gop alarmists who sit on this dais. we are barely four weeks into this one and already declaring it dead. it is premature death. we would have loved to see this launch be seamless and smooth. we can't get caught up in the glitches and technical difficulties and lose our
3:31 am
perspective. help lines are up and running. i want to put the first chart up because i think you need to know that it's working in some states in this country. we've had a health plan finder in the state of washington out on the street before october 1. in what state we were ready to go and we have got 92,000 people who have now enrolled. there is a difference between enrolling and being approved, having your plan approved because you have to make your first payment. when you talk about enrollment, you may be talking about something different. people can sign up by mail, in person. we had actually a mobile sign-up van that is going around the states, stopping in small towns and giving people a chance to
3:32 am
talk to somebody. 49,000 people are already in the program. not just finished the application. there have been some glitches, even in our state, but we got around them. our country does have a serious problem, however, with access to quality health insurance. it's not being caused by websites. all the computer programmers in the world aren't going to be able to help the 180,000 hoosiers that fall into the affordable coverage gap because indiana isn't expanding its medicaid. of course, that's nothing compared to georgia's 400,000 people who aren't going to get anything or florida's 760,000. then of course there's texas. texas is always the best and they are not going to be outdone. boasts 1,426,430 people who will simply get nothing. no medicaid and i guess they can
3:33 am
come to the government exchange which people here want to kill, but that's over 1 million texans working poor, with minimum wage jobs, multiple of them, and they are just trying to get by. they could be covered at no cost to themselves or the state of texas, but instead the gop wants to see this president fail because they would rather let their constituents go uninsured than compromise. those texans and floridians and hoosiers are simply out of luck. meanwhile, in other red states like kentucky, they've enrolled already. 26,000 people through the state exchange or expanded medicaid. arkansas. they don't want it either. they don't want to accept the medicaid money. they constructed their own way in cooperation with the federal government and they've got 56,000 people enrolled in arkansas.
3:34 am
here is a red state that worked hard to part with the federal government and arrive at a solution working with its residents. it's time to start working together. 44 attempts to repeal this law. it's now a law, folks. it's up and running. it's going to run and time to stop this kind of sniping and get together and figure out how to make it work. no one on our side thinks the law is perfect. >> thank you. time is expired. mr. ryan is recognized. >> thank you. i think we are seeing all these rude awakenings that the american people are waking up to find. promises made and promises broken. we had a hearing august 1st with the irs. the irs confirmed that the tla in the employer reporting requirement was mean the irs would not have the data on the back end from employers until 2016 to verify if an individual
3:35 am
had been given an offer of affordable employer employee in 2014. to mitigate this, dan wuerffel told us we are going to help the individual at the front end when they're navigating through the exchange to understand whether they have an employer plan. let me ask you this. of the 700,000 applicants you received, how many of them did you verify whether or not they've been offered or have employer sponsored insurance? >> the verification of employer-sponsored insurance is part of the application process. so if in fact that was available to them, they would not go on and complete the application. >> you had no way of corroborating? >> we actually ask additional questions. if you go through the application, it requests additional information. we have ways of verifying
3:36 am
whether or not employer-sponsored coverage was offered. it's not as simple as yes or know. if it's yes, we try to work with them to see if they are eligible for anything or not. the report admits these estimate does not take into account the tax credit eligibility requirements to minimum coverage or tax filing requirements. young adults on their parents' plans. are you proactively finding out if individuals under the age of 26 are eligible, who are eligible to stay on their parents' plan are doing that or not? they are not eligible for a subsidy, as well. >> what we've seen since the affordable care act we have over 3 million young adults who are getting coverage through their parents' plan, the pool we
3:37 am
anticipated. they are going through their parents' plan. >> when they go on the website, are you verifying whether or not their parents have a plan they are eligible for before determining whether they themselves get a subsidy? >> it is part of the application process. i can get you more information on that. >> here is the point two. weeks ago in the cr we passed a law president obama signed, prior to make credits and deductions available, they shall certify the exchanges verify such eligibility consistent with the requirement of the act. here is the question. are we really verifying at the front end whether a person's actually eligible for these subsidies or not? here is why this matters if they are not eligible for this subsidy and once we reconcile these records, they get taxed the money back. off of their refund. this is what i mean when i say rude awakens. people are signing up for
3:38 am
insurance. getting tax credit subsidies funded by taxpayers. the irs is confused about how to do this. you're not telling us whether or not you're proactively determining whether a under 26-year-old is eligible for subsidies you are trying to sell them. the problem is once we learn whether or not they were eligible and if they weren't, people in good faith will be signing up for subsidies they are not eligible for. >> i think you are asking a different question which is are we doing 100% income verification on income. >> skept eligibility verification. >> yes. are you dependent on your parents? are you dependent on your parents' tax plan. that is part of the question that goes on. if so, we move them in that direction. more importantly, part of what you're asking is the income verification which is done 100% of the cases. >> i'm not asking about income verification. if a person signs up, were they
3:39 am
offered credible employer insurance. because the employer may have been delayed, you don't have that verification tool so you had to come up with a new verification tool to determine eligibility of subsidies. if they are offer insurance at a job that meets your definition of credible insurance, then they can't get obama care subsidies. if a person is 25 years old and go on the website and say their income is x and eligible for subsidy, they can get that subsidy. if they were eligible to be on their parents' plan they are not eligible for that subsidy. are you filtering that? >> yes. >> here is the problem. if you get this wrong? the way the law works, you have to take that money back in their tax refunds. they plan their lives with their tax refunds. >> i understand that. >> if you get this wrong which you already acknowledged you're not doing it right, they are going to get their tax refund
3:40 am
getting away from them. >> including the fact you are basically completing this application under penalty of perjury. it's very clear. there is also help instructions on each site to explain each process, what is credible employer coverage, what happens if you're under 26. it is all available on the website. >> if they get it wrong, they will get taxed. >> time expired. mr. lewis. >> thank you, mr. chairman. thank you, madam administrator for being here. thank you for all your hard work and your years of service. i happen to believe that health care is the right and not a privilege. it is not just for the fortunate few but all citizens of america. the affordable care act is the law of the land. it was passed by the congress,
3:41 am
signed into law by the president of the united states and upheld by the united states supreme court. there have been more than 40 attempts to repeal the act by attempting to repeal it, members of this body, members on the other side of the aisle closed down this government and threaten the economy for the united states, costing us more than $24 billion. just remind me of another period in our history. not so long ago during the 50s, many southern senators signed a southern manifesto after the supreme court decision of 1954. those senators along with many southern governors subscribe to the doctrine or interposition and notification, and some even
3:42 am
massive resistance. that's what we saw on the part of the republican members of the house and some of the republicans in the senate. the affordable care act is working. it is helping to make health care affordable and accessible to a hundred thousand million of our citizens. when i was growing up we couldn't afford to see a doctor. poor people in alabama, georgia, in kentucky, in arkansas and all across the deep south couldn't see a doctor. we must do what is right, what is fair and what is just. madam administrator, i have a chart here this morning and i want you to walk us through this chart and i want to use my remaining time for you to explain to the members of the
3:43 am
committee the success and the benefits of the aca. there have been a deliberate and systematic attempt on the part of the majority in the house and the minority in the senate to make it impossible for all americans to receive quality health care. some of us will not stand for it. we will stand up and fight for what is right, for what is fair and what is just. health care is a right and not a privilege. walk us through the chart. >> let me start with many consumers save $3.4 billion on premiums. these were benefits that went in forms of checks to individuals. i got thank you notes from people that i never heard of that i never met thanking me for getting some rebate back. it could go to the individual or back into their premium for the following year. 17 million children with
3:44 am
pre-existing conditions were used to be able to be noncoverage. this goes back to the flaws that existed prior to the affordable care act. 6.6 young adults able to stay on their health insurance plan that. was critical at the time with what we were going through with our economy. 7.1 million seniors in the donut hole. let me remind you in addition to that you saw our release yesterday about the part b premium being flat next year. that is some of the work of the comfortable care act and controlling costs. going back to your point, congressman, is if we had the highest outcomes, if we had the lowest infant morality if we had the lowest life span, maybe what we were paying would be worth it, but it's not the case. p as you know, our country does not look good in terms of overall health statistics and certainly the south is suffering from that more than the rest of the country. >> thank you very much. with that i yield back my time.
3:45 am
>> thank you. mr. nunez. >> madam administrator, in response to mr. ryan's question, we went through the remember site and we don't see anywhere where it shows if you're under 26 there is a verification. >> let me also say one thing that i had wrong. as a young adult, you can stay on your parents' policy and you can get your coverage that way. >> the question was there was no check into subsidy. >> or go as an individual and be eligible for a subsidy. >> if you're under the age of 26. you can get a free subsidy and get that back on your tax return. that was the point mr. ryan was making. >> you're eligible for a subsidy, yes. >> you can be on your parents' health care and eligible for the subsidy. >> part of what you complete on the application is do you have coverage. you're also under penalty of perjury so you have to tell the truth on your application. that's kind of a requirement. >> okay.
3:46 am
>> in your submitted testimony you attributed the problems to a subset of contractors, is that correct? >> i don't think i said that it was due to a subset of contractors. we had two issues that we were dealing with. the first was capacity. our first few days the volume was more than anticipated. we had a problem with account creation, with the e-mail account creation which was subsequently fixed. >> on your august 1st testimony to the house energy and commerce committee, to congressman pitts' question, do you remember this question? >> you'll have to ask the question. >> he asked, do the contractors who hhs is paying to build these exchanges have milestones they have to meet? you replied absolutely. congressman pitts asked you, can you tell us today every contractor met these targets and is on time? you replied yes, sir, i can.
3:47 am
it seems there are two possibilities here. he repeatedly told congress and the breakdown resulted solely from problems with a few contractors that suddenly occurred 60 days before obama care was open to the public or the second possibility is if there were problems earlier that were being reported in the press that you did not tell congress about these. which is closest to the truth. >> if i remember the questions correctly, what congressman pitts was asking me related to the hub and the hub was progressing on time and on schedule. still is. the hub has actually operated flawlessly. most of the questions were around the hub. >> neither criminal background checks or high school die employmentas will be required to help access the exchanges. >> neither high school diplomas
3:48 am
nor background checks will be done on folks you hire to help navigate the obama health care website? >> i don't think that is true. there are standards. i can get you those standards. >> okay. it's been a press report. has anyone in the white house or anyone else asked you to delay divulging enrollment numbers as regards to mr. camp's question at the beginning? >> no. i said we would release our first numbers middle of november. >> so no one at the white house, no one in the obama administration has asked you not to release those numbers? >> we have made a group decision we were not releasing the numbers till mid november. >> you have no idea what those numbers are at this point? >> told you we would release the numbers in mid november. >> i'll take that as you don't want to answer the question.
3:49 am
did you ever argue to secretary sebelius or anyone at the white house or anyone else that the exchanges would not be ready october 1st and that a delay in launching them would be warranted? >> i did not ever argue that we should delay the exchanges. what i did present to secretary in september is there were certain functions we should delay beyond october 1. i think those have been very much in the press that had to do with the automation of shop. it had to do the spanish language website. had to do with medicaid-mal transfers. >> before my time expires, i want to yield quickly. >> the law is if you are under the age of 26 and you are eligible to stay on your parents' plans, you cannot receive subsidies. >> you're right. >> there is nothing, nothing on
3:50 am
your website that tells an under 26-year-old those facts. so you're encouraging people to sign up for insurance and a subsidy they may not be eligible for and don't know this. >> congressman ryan, i am happy to check on that and get you information. >> i think one of the differences here in the legislative modeling is the way we attempted to repair the drug prescription benefit known as part d in terms of addressing the donut hole. we didn't suggest we wanted to repeal the law. we simply said to repair it. and remind everyone part of it was gimmickry as it related to the donut hole. let's improve it in the affordable care act i think you could safely say that has happened. i want to go to a broader argument here. that is that 97% of the people in massachusetts are covered. virtually every child in massachusetts is covered.
3:51 am
we are in the midst of marketing the open enrollment plan. so people right now, and i've got to tell you marketing is terrific. i want to come to another point. that's the following. there is a great picture at nathaniel hall where much of the american revolution was designed and hatched of governor romney or as we know him on this committee, paul ryan's running ma mate, the other guy on the ticket. ted kennedy, the heritage foundation and the governor sets his hand to this legislation, which has become a model for applicabilty, efficiency and success. hardly perfection.
3:52 am
but what a grand possibility why. in your estimation has the massachusetts plan worked. >> i think if the massachusetts plan over time has allowed individuals to not have to worry about pre-existing, it's required they have insurance, it's required that they participate in group coverage, group market, it's the same principles we applied through the affordable care act and it's been a huge success. they started out very slowly. it took them years to get to where they are today. they do have good coverage. if you look at their outcome they have excellent outcomes, as well. >> the business community worked with the governor, worked with a democratic legislator that has three republicans in the state senate, and they came to the conclusion that using the discipline of the marketplace could be part of the solution. and getting everybody in was the ideal.
3:53 am
then we would argue about many of the other matters, but getting everybody signed up was a key component. we would use the private sector to discipline price, correct? >> that is correct. >> so i guess the argument we have here is why wouldn't we be trying to sand the edges of the aca to make it work as opposed to this determination to make sure that it doesn't work? yield back my time. >> thank you. mr. teaberry is recognized. >> thank you, ms. tavenner. you've got a great reputation. you this for your service. you have a very difficult job to do. best of luck in doing it. i want to make a note to you and to the members of the audience here. september 30th the republican
3:54 am
house passed a resolution funding government and delayed the individual mandate in the implementation of this bill. that was on september 30th. that died in the senate, delaying this for one year. the reasons why we believe that was the right policy, and i think history will show that it is is what we've seen in the 28 days since. that is the disastrous unveiling of this bill. you don't have to be a member of congress and talk to constituents to understand the difficulty that the implementation has caused into people's daily lives. as mr. brady said, the nervousness and the fear. you've been telling us that there are other options in addition to the website. the president has gone out and sold that pretty well. so if the constituent of mine goes and makes the phone call to try to find out some
3:55 am
information, can she find out by calling the phone number if the doctor in her current network is covered? >> she cannot find out through the phone call. that was true in the market prior to the website. >> can she find out if the plan costs more than her current plan? >> yes. i think she can find that out. >> by calling the phone number. >> what happens they work them through the application. >> she has to actually apply before she can shop. >> well, yes, that's important. it's important to understand if she is eligible for a tax credit because that would affect the price she would pay. >> can she find out the cost of the plan without signing up or comparison shop without signing up? >> if you're not interested in the tax credit and you judge just want to know what rates are available, we actually have on the website the ability to do that. >> but the website is not working. >> no. this is on the front end.
3:56 am
what is not working sometimes or some of the pieces inside the application. if she is just interested in rates and her market available through the website, there's also the ability, and we have a link with that on the website to use kaiser's side if they believe they are available for tax credits that would simulate what it would look like for them if they just want to know what is available to them, which i had several friends who said i know i'm not eligible for a tax credit, i want to see what rates are available in the individual market. >> but they have to sign up to do that. >> no, they do not. >> you're positive on that. >> i am positive on that. >> isn't the person who is on the phone with my constituent who is trying to find out if their doctor is in the network? >> no. doctor in the network is not available. >> person is making the phone call. my constituent is talking to somebody on the other line. aren't they accessing the same information on the website that
3:57 am
our constituents are encouraged not to do because the website is not working? >> two different issues. if they are completing an application, they would complete the application and we would give them information. if you're just interested in knowing what the insurance rates are in your area, that's actually available without completing an application. you can just go on the website and get that information. >> but if they are accessing the phone network because they can't access the website -- >> they can give them that information. >> isn't that person they are talking to accessing the same website? >> yes, but it is not inside the application. >> you are asking people to call and talk to a person who is accessing the same website we are encouraging our constituents not to use because it's not working right. >> let me try this again. the problem we have in the website sometimes is in the application process itself. inside the application people were getting stuck in the application process. what you asked me is can you get plan information without
3:58 am
completing the application process. therefore, not getting into the problems and the answer to that is question. >> let me tell you the concern that i have. the members on the other side of the aisle won't acknowledge. we understand the affordable care act is the law of the land. we do. but we also understand from our constituents that there is a disaster of a rollout that's occurring, not a hiccup but a disaster of a rollout that's occurring. i have constituents who said to me their doctor is not going to be covered in the new plan. their plan is going to be more expensive. finally, a constituent who said, let me get this straight, congressman, you guys passed a bill that tells me that i'm transitioning, you're telling me to transition to another plan and you're telling me what that plan is going to be. it's not going to have the same benefits that i have now. i'm going to pay more, but
3:59 am
you're going to give me a tax credit back so i can pay less even though it's going to cost more. that's crazy. for us not to acknowledge that's crazy is just so disappointing and discouraging. >> time expired. >> mr. doggett. >> thank you, mr. chairman. while i am troubled by the determination of our republican colleagues to destroy the rights of americans to access affordable health care, i recognize the promise of affordable health care can be denied through management failure. i share some of the concerns that have been raised here this morning. if there were even one republican member of this committee who wanted to fix the shortcomings in the act and to learn lessons from the rollout about how to improve access, we could have a constructive hearing that focused on those limitations and how to address them. at the top of the list for any texan would surely be the million people that when we thought we were providing
4:00 am
protection when we enacted this law who are getting absolutely nothing out of it. the limitations with the website are a part of the concern that i have. let me ask you specifically will the shop website for small businesses that was delayed be fully functional during november? >> yes. we will institute the shop component at the end of november. >> will the twice-delayed spanish language version be fully operational in november? >> by the end of november, yes, sir. >> there are estimates that 3-4 eligible individuals for the website need some -- eligible for tax credits will need some assistance to navigate that.
4:01 am
in large measure because of the statute, people in maryland get 15 times as much money per individual uninsured eligible for the exchange for the tax credits as do people in texas. people in california get about four times as much. it makes it all the more important that the navigator system work as well as the web system works. i've had some concerns about the way that navigator system works and have been asking whether it is possible to get proper reports about whether the navigators are doing their job and whether they are accessing people, whether by paper, phone or web. i've been told that there are no progress reports that will be available on those navigators and what they're doing until after the beginning of the year. surely, there are some reports that you can make available that
4:02 am
will tell us whether these navigators are doing any more than the little i've seen them do in my part of texas? >> yes, sir. you should not have to wait till the first of the year. >> you can get us progress reports? >> yes, sir. >> when you announced the navigator grants for texas, there was an indication in the original notice that there would be a second round of navigator branch. instead it appears contracts were reached with two national firms to provide enrollment assistance. those firms are at least required to provide in some cases weekly reports on their progress. in what way are those enrollment assistants, two company. i believe the one for texas is cognisante. they got a total of about $30 million, much more than any individual entity as a navigator in texas. in what way are they being
4:03 am
integrated with the local navigators and assistants counselors? >> i can get you that information. i will tell you we obviously -- there are navigators inside each of the federal states, federal exchange states that we awarded contracts to. in addition to that, there are volunteers to the texas hospital association and others. i can get you a full report of that. >> today is not the first time i asked for a full report as to how these enrollment assistant folks came into being and how they are involved with local folks. we had to set up in san antonio and in austin our own network to try to make up for what we did not get in the way of federal assistance at the local level. these new enrollment assistance
4:04 am
people, i'm interested in progress reports to see what they've done. if they signed people up and what kind of people they are signing up. and whether the navigator system, the certified counselors are any better organized and coordinated than the website and the 55 contractors have been? another area of concern -- >> time is expired, mr. doggett. >> thank you, mr. chairman. this all started out on a troubling notoriety from the beginning. republicans were not a part of the process, weren't asked to be a part of the process in building this law. nancy pelosi herself said we must pass the law to find out what's in the law. as one of my colleagues mentioned this morning, let's sand around the edges. we have done some sanding around the edges, and that's due to the fact republicans have been calling attention to some of the issues that now we are becoming aware of because people are now
4:05 am
beginning to read the law and finding out what's in it. so three programs have been completely halted since the law has passed. seven others have been repealed and have had funding rescinded and have been signed into law. that takes republicans and democrats and the president of the united states to agree to all those things for those things to happen. i think most people feel right now it's not time for any sanding to take place but to chainsaw needs to come out. so we are going to keep on and we are going to be persistent. were you working for cms on january 29th, 2010? were you part of the process in working to help implement obama care? >> i actually was not working for cms january 29, 2010. >> when did you start working to
4:06 am
implement the health care law? >> i actually came to cms late february of 2010. >> do you know if you can keep your health care plan if you like it? >> do i know if i can keep my health care plan? >> do you know if it's true, as the president has said and many democrats have said, if you like your health care plan, you can keep it. is that a true statement? >> there were health care plans -- >> is that a true statement? >> it is a true statement. many plans were grandfathered in. >> if you like your doctor, you can keep your doctor, too? >> i think doctors come and go inside networks. >> if a doctor is in a network, they can still go to that doctor? >> if that person is in a plan where the doctor is in the network, they can keep that doctor. >> on january 29, 2010, and it's
4:07 am
been reported even today in some of our papers, the president knew years ago, you're not going to be able to keep your health care plan, you're not going to be able to keep your doctor in this health care plan. he talked to the republican retreat on january 29, 2010. he said when asked the question about keeping your doctor or your health care plan, he said, quote, we said from the start that this was going to be important for us to be consistent saying to people if you can have your, if you want to keep your health insurance, you've got it. you can keep it. that you're not going to have anybody getting in between you and your doctor and your decision-making. then he says, i think that some of the provisions that got snuck in might have violated that pledge. are you aware of some of those
4:08 am
provisions that got snuck in that might have violated that pledge? >> i do not know what you're talking about. >> i just gave you a quote from the president of the united states, your boss. >> you're asking me provisions snuck in. >> you're not familiar with the health care law? >> i'm very familiar. >> the president is aware of some provisions snuck into the law that says you're not going to be able to keep your health care plan. you're not going to keep your doctor. you just said you can. you must not be aware of -- you didn't read the law as nancy pelosi said you should when the thing was passed. otherwise you would know about those provisions. in quarterbacks state, my constituents can't keep their health care plan. 290,000 individuals in washington received notices canceling their health care plan. do you know that's happening? have you heard those stories? >> i am aware that there are
4:09 am
issuers in states who are cancelling their old plans who are grandfathered in and moving to new plans. >> what you just said about keeping your health care plan isn't true. >> you can't keep it. the president says you can't keep it. why are you saying you can? i don't understand? >> time has expired. mr. thompson is recognized for five minutes. after that, in order to make sure everyone has an opportunity to question, mr. levin and i agreed to go to three minutes. >> can you start the clock? >> we'll give you those ten seconds back. there you go. >> thank you, mr. chairman. ma'am, thank you very much for being here. i want to thank my colleague from california who earlier pointed out that it wasn't you or cms that set up this computer system. that you used private sector outside vendors. i think that speaks to an issue
4:10 am
at some point we need to look at. that's our federal procurement process which is in part responsible for a lot of the problems that we've seen. and also want to thank mr. neal for pointing out in fact when we worked together, we can avoid a lot of the problems that we're seeing. we should be working together to make sure people have access to quality affordable health care rather than trying to find fault and blame and trying to defund or derail or sabotage a program that is designed to help people have access to quality affordable health care. nowhere is that more seen better than looking at what we are doing in some of the states. it's my understanding and some of my colleagues have pointed it out today we have some states that are doing a pretty good job with their delivery of the
4:11 am
affordable care act. my home state of california has something called covered california. i understand we had about 125,000 applications that have been submitted. about 2 million unique visits to the website. about 150,000 calls daily to covered california because people really do want to have coverage. there's been many benefits in my home state. about 200,000 people are covered with preventive care. about 40,000 kids who have pre-existing conditions now have coverage. about 100,000 seniors are getting preventive care under medicare. i've had a number of people who contacted me. i'll mention two, samuel calcurry who said he was paying 131 a month and now he is paying -- a week, and now he is
4:12 am
paying $45 a month for coverage. cynthia adams from santa rosa was paying $600 a month and now is paying $134 a month. in full disclosure as i mentioned to you privately, i've had some terrible messages from people who are experiencing some real problems with the system. usually it's insurance companies as some of my colleagues have mentioned are canceling their grandfathered-in programs and issuing new policies. i even had a community college in my district using the affordable care act to reduce hours of part-time employees. just about everything that's happened that's been bad in the last three years has been associated with obama care. we need to be able to draw the
4:13 am
distinction and point people to these exchanges so they can do some comparison shopping and get policies that will provide them with insurance. i would like to see you guys do a more aggressive job in regard to that. i would like to know from you, ma'am, how are the state exchanges working? what effects are the problems of the federal remember site having on state-run exchanges and how are the new upgrades in the website fixes going to affect state-run exchanges such as covered california? >> let me say that the state-based exchanges are doing a very good job. california as you mentioned has been a really nice success story, but there are large and small states. california and new york are huge states having great success. where we've been able to work closely with them and we talk with them daily is obviously they use the hub for verification of information. the hub has worked pretty much
4:14 am
flawlessly. i always knock on wood when i say that. they've been able to get information. the problems we are seeing inside the application process do not affect the state-based exchanges. the information they need from us they are able to get. you all may have been aware there was an incident over the weekend with verizon that took the whole site down. when it did, it took down the hub. states were impacted during the day on sunday and into monday. with an issue with verizon. other than that, they've been able to come and go and access the hub without difficulty. >> thank you. i yield back my time. >> welcome. good to see you. i think in answering chairman camp you established the fact the nation's 2.7 million uninsured from 18 to 35 years of age, you're not going to reveal numbers on who is enrolled in that age group until some time
4:15 am
in mid november. is that correct? >> yes, sir. mid november. >> same goes for applicants? you will have no metrics on the number of applicants in that age group? >> we will release our metrics in mid november. >> how confident are you those in this age group will actually sign up for the exchanges given they don't actually get information on the plans unless they actually go through the application process? >> you know, we've actually had feedback from individuals who have worked through the application process who signed up. there have been good representation, good stories in the young age group, as well. >> this is a tech-savvy group. they are already being confronted with major barrier with the website problems. as you said earlier, aca is much more than a website. we all know they are going to see higher premiums, particularly in that age group. there's been a number of reports
4:16 am
and studies that demonstrate that's going to be the case. clearly, the penalty is much lower than the cost of the insurance. knowing something about the behavior of this age group, i have real concerns that we are going to see adverse selection. >> congressman, i would remind new this age group, many will be eligible for tax credit. that will help with their premium costs. also for those under the age of 30, there is an alternate catastrophic plan. >> if premiums go up, subsidies go up, is that correct? >> those subsidies are based on your income. >> we know there is upward pressure on premiums. >> it's been about 18% below what cbo estimates were. we have a good story to tell there. >> we see other evidence going
4:17 am
longer term that we are going to see upward pressure on premiums as a result of the construct of this law. i spent 30 years in medicine. i understand what this is going to do. i have very deep concerns about what we are going to see with premium costs. as premium costs go up, subsidies go up. that means the burden on the taxpayer goes up. that means deficits go up. >> i will remind you that premiums were going up at double digit increases prior to the affordable care act what we are seeing is a moderation in increases in the last three years. >> that is a false dichotomy. there are other solutions getting premiums down and lowering costs. i don't accept that as a complete answer on the cost of these pleem yums. transparency is clearly very important. will you or hhs or cms, somebody in the administration provide information on the taxpayers' cost with regard to these
4:18 am
subsidies for 2015 and beyond? >> i am sure part of our information and reports we produce will include that information to you, yes. >> thank you. >> thank you very much, mr. chairman. i would like to associate myself with the remarks of mr. thompson and mr. neal. i'll focus on an area i think this committee could become imminently involved in. i would like to point out what a success connecticut has been. i want to commend governor malloy and lieutenant governor wyman who headed that up. tremendous success including more than 1/3 of the people that have signed up for the program are under age 35. so it demonstrates when you're working together and cooperating, that indeed these things can work. as mr. neal pointed out, the thing that is astonishing from a democratic view, if democrats were to have their way in health care, we would have had medicare for all or a single-payer
4:19 am
system. instead we opted for coming together and ending up with a program that was idea, the concept was the heritage foundation piloted by a republican governor in a democratic state. so we come up with a private sector initiative. here's the deal. the deal is this. that if this committee were to approach this issue the same way we did tax reform and say the following, we are going to take the very best of the public health system, the very best of the public health system including the national institute of science, national institute of health, centers for disease control, everything our public health systems in our state has brought together over these many years, and do that in combination with the private sector so that we can take the entrepreneurial advantage that the private sector can bring to this remedy. then that takes science and
4:20 am
technology, most notably the genomic project going on with untold benefits. what the american people want to see is to help them out, to solve their problem, to help them get better health care. they don't want to see this endless tastes great/less filling debate from the committee. i challenge the chairman. let's do what we did with tax reform. break down to individual groups and solve this problem together so we are taking the best of the public sector, the best of the private sector, and all that innovation technology can bring to bear on changing the paradigm for the american citizen. so it's their health and well being that becomes the focus, not the ideology of either party. but the health and well-being of the american citizen. that's what this should be about. we can do it. by taking both sides of what
4:21 am
both parties and both ideas can bring to this discussion, the best of the private sector, the best of the public sector and everything that science and technology and innovation can provide. there's more than $800 billion annually in wasted inefficiency. this is the most inefficient economic system in the world. can't we come together to solve that? use this committee to lead the way and set the example for regular order can provide by challenging everybody to sit down as we have in tax reform and come up with a solution for the american public, not this ongoing debate. >> time has expired. >> thank you, mr. chairman. administrator, thank you for your time today. i have an independent recollection driving around chicagoland. it was june 2009. president obama was in town
4:22 am
giving the speech to the ama. i knew i was going to be called on to make comments after so i'm listening to it. i'm on michigan avenue downtown chicago. i'm listening. the president says a paragraph you're familiar with. i want to revisit it with you now in light of constituent contact i had. he said, i know there are millions of americans who are content with their health care coverage. they like their plan and they value their relationship with their doctor. that means that no matter how we reform health care, we will keep this promise. if you like your doctor, you'll be able to keep your doctor, period. no asterisk, period. no one will take it away no matter what. my view is health care reform should be guided by a simple principle. fix what's broken and build on
4:23 am
what works. that was a declaretive statement by the president of the united states. that deeply resonated with a lot of folks. he repeated it. made other claims like if your coverage is going to save $2,500 on average per family and so forth. here is my point. diane is a 57-year-old breast cancer survivor. it was reasonable for her to assume based on the plain language of the president, not subsequent parsing, but the plain language of the president that she would get to keep her coverage. here is her new reality. she gets the letter from blue cross/blue shield that says that they're unable to offer that coverage. her rate goes from $363 a month to $713 a month, almost doubling. now, she had a pre-existing
4:24 am
condition. this is not a question of whether her breast cancer was covered or no she is being moved into a gold plan which presupposes she had decent coverage from before. can you understand the level of frustration and concern about what many americans perceive to be a false claim from the administration? not that it was somehow changed or now that, well, we've got this wonderful plan for your life that says we no better than you, we're going to tell you what kind of coverage you want. diane knows exactly the type of coverage she wants. that's one concern. the other concern is the website. denise is a professional in this arena and spent countless hours advising clients. the advice is take screen shots, protect yourself and so forth. my time is expired, but can you understand at least the level of
4:25 am
frustration based on the claim of the president of the united states that people were going to be able to keep what they had and it's not turning out to be true as they understood that statement? >> i understand that for about 86% of america that had employer-sponsored insurance and were satisfied with those plans and they still have those plans what we were dealing with in the affordable care act is the individual market where the constituent you talk about is lucky. she was able to have insurance. many people were blocked out due to pre-existing, due to other issues. that's what we were trying to fix. that's what i understand. >> all right. >> if i ask a three-minute question will the administrator have the chance to answer also? >> give it a try and we'll see. >> thank you, mr. chairman. i would like to just dive in a little bit to follow up on what
4:26 am
my friend peter was talking about. frankly, the sheriff acting like a district attorney with you a little while ago. have we ever had the ability to force a doctor to stay in a pick plan? is that sometimes beyond the control of the patient and the doctor in terms of networks? >> that is correct. doctors always have to individually negotiate. >> we can have a framework, but you're not going to be able to force doctors to stay or insurance companies to keep them. they change all the time, don't they? >> that's correct. >> and this notion that somehow we would force insurance companies to never change policies, haven't we seen 1/3 to 2/3 of the individual market change in the course of a year for the typical patient? >> absolutely. >> request so it's not anything that my friend from the state of
4:27 am
washington, which has 7 million people, arguably at least a million households are either uninsured or in the individual market, that they would see several hundred thousand people every year who would who would individual policies change, is that not true? >> that's true. prior to affordable care act, what they were assured of, were they going to lose their coverage and what was going to happen through premiums. we've stabilized the premiums and no longer allowed denial for any preexisting and we're creating a more competitive market and washington is a great example. >> many of these people subject to the churn, it's because they find out they try to use the insurance and find out, wait a minute, it's great insurance until you get sick or until you
4:28 am
bump up against artificially low caps or having moving targets as insurance companies do deeper dives about eligibility. isn't that part of the churn? >> that is true. >> is that going to be possible any more that people will have limits and get thrown off? people will be able to go back into the history and throw them off? >> they will not. >> mr. chairman, part of what is i find a little disconcerning is that people are in a little never never world where they think that in the past we've been able to force insurance companies to continue to offer. they've been able to force doctors to be in the networks. this is entirely consistent with the intent of the affordable care act, to give them superior insurance without those problems and i do think that we're not really talking about apples and oranges. thank you, mr. chairman.
4:29 am
i'll yield back. >> thank you, mr. chairman. thank you for testifying today. first i want to get to a question raised by chairman nunez about the release of numbers as total number of enroll ees to date. you said you're not going to release numbers until mid-november. you said we made a group decision not to do that, not to release them until mid-november. who was part of that group to make that decision? what were the individuals that were part of that group's decision? >> i think it was in response to the question was did the secretary or the white house direct me and the answer to that was no. this was a group decision. we actually sat down with the secretary and talked about what would make sense in terms -- >> who was the group? that's what i'm asking. individually who made up that group. >> these were different components within hhs, different operating divisions and obviously we had conversations with that with white house staff
4:30 am
as well. >> who was the white house staff you had conversations with? >> this would be members of domestic policy council -- what were the names? >> i don't recall. these were a different of series of meetings -- >> aware of memos or e-mail exchanges regarding different component group numbers? >> i'm not sure but i'm happy to look at that. >> if you can take a look at all of those memos and if you have those, can you share those if you would? >> secondly you indicate that the problems that are being experienced with the website is based quote unfortunately on a subset of contracts for healthcare.gov that have not met expectations. is it the contracts that have not made the expectations or is it the contractors implementing the contracts that have not met expectations? >> i'm not sure which quote you're referring to -- >> bottom page one of your testimony -- page two of your
4:31 am
testimony. unfortunately a sub set of those contracts for healthcare.gov have not met expectations. so is it the contract that have not met expects or specifications of the contracts were not properly developed or executed or implemented or is it the contractors themselves that took a good contract and did not perform properly? >> i think in the case of the ffm site is what i was referring to and we've been working with the contractor. we've had issues of timing of delivery -- >> who is that contractor? >> that is cgi. >> it's the contractor in that instance that's not meeting expectations. >> yes, but we're working with them. >> are you going -- are there provisions in contract with that company that if it fails to perform in any substantive way that it is to repay or refund back to the government for funds
4:32 am
that you have allocated to it for the purpose of performance? >> i can get you the details of that. >> there's also a tech surge under way. >> the time is expired. >> despite our democrats opposition to part d ten years ago, we committed to making best of the program and because of all of the changes that have occurred in part d prescription program, 90% of seniors right now are satisfied. and why are they satisfied? well, in my district, before that, i made seniors know that i was going to vote no and told them two reasons, the gap the doughnut hole when you're paying for premiums you're not getting benefits. this was horrendous. and number two, no one was -- an outside source -- of the
4:33 am
prescription drugs. we lost a policy fight. we went back to our districts and we told our seniors we voted no, we're -- we personally believe and we'll work with the bush administration to make it work. that's what we did. and how many of you stood up to do that? none, zero, zero. let's talk. let's not water the wine here. let's say it like it is. you refuse to expand many governor governors, they refuse to set up marketplaces and leaving millions on the table in education funding. what happens? well, for those -- here, the floor of the committee and off
4:34 am
the floor of the house, what are you going to do about the approximately 17 million children with preexisting conditions who can no longer be denied health insurance coverage. we want to go back and want to say you are no longer covered any longer. are you going to tell the parents of those kids? which one is going to stand up and tell the parents of those children that the game is over, sorry, that was just -- >> will the gentleman yield? >> yes, i will. >> i will just tell you -- where are you? >> right here. you asked a question and i'm going to answer it. it's a false choice to say it's obama care or nothing. there are numerous proposals including one that i'm a co-sponsor of -- >> i take back the time, sir. >> let me take the time back. are you serious what you just said? are you really serious? after what we've gone through and what we've gone through in the last three and a half years? have you -- you can sit there
4:35 am
and say, that you had a legitimate alternative after these years? we've gone through 44 votes, 48 votes now of you trying to dismantle the legislation. you call that cooperation? i don't. >> will the gentleman yield? >> you asked a question. >> the gentleman's time has expired. >> reit's redundant. >> thank you, mr. chairman, welcome madam administrator, i appreciate your testimony today and the work you're doing. i think the american people are looking into this -- at this hearing and just shaking their heads. because it -- i spent over 20 years taking care of patients and this is about patients. what we on this side of the aisle want is the highest quality of care for all americans, a system that is affordable and accessible and provides the greatest number of choices and continues innovation in or health care arena so folks
4:36 am
can have the highest quality care. but our belief is firmly and i believe it's playing out now that the aca violates everyone of those principles. that's why we oppose this policy. there's not enough time to correct all of the record that has been stated but here's an article from the "new york post." elderly new yorkers are in a panic after getting notices that insurance companies are booting their doctors from the program as a result of shifting landscape under obama care. quote, united health care told dr. lebowitz that because of significant changes and pressures in the health care environment, he would be getting the axe on january 1st. not that they were trying to force them into it, but that he would be getting kicked off the program. forcing insurance companies to change their plan, you bet they are. here's from care first, maryland, individual sent me this letter. the aca requires you to pick a new plan to maintain coverage because your current plan will
4:37 am
cease to exist at the time of your any newal through the aca. >> without objection the letters will be in the record. >> i have specific questions i'd like to have you answer. when did cms become aware of the problems with the website? >> i think cms became aware of the problems within the first week and we had the volume surge. >> cms didn't have a clue there was going to be a problem on october 1st when the website went live, is that correct? >> the problems that we saw in the first week, we attributed to volume, once it started -- >> how about before october 1st? any sense at all there would be problems with the website? >> no, not -- there are always going to be issues with a new website, the customarily glitches you see, but not this. >> did you have any meetings with the white house prior to the rollout date on october 1st to inform them of any problems you anticipated? >> no, not any problems i
4:38 am
anticipated, i talked earlier about programs that we decided to delay, the shop and spanish -- have you been involved with any conversations with secretary sebelius or the administration about delaying the individual mandate. >> about delaying the individual mandate, no, we discussed the individual mandate to some degree but not about delaying it. >> there was a hearing last week and in energy and commerce cgi, one of the contractors said there is hidden source code on the site that says applicants have no reasonable expectation of privacy and this was due to a decision that cms made. did you all make that decision? >> i will have to get back to you on that. i'm not sure what they were talking about in that comment. >> thank you, my time expired. >> mr. crowley. >> thank you, mr. chairman. miss tavenner, i think you were asked 22 times when the information will be available.
4:39 am
just to clarify for the last time, that information will be available sometime at the end of november, is that correct? >> that's what i said, mid-november, many times. >> make this clear to all of my colleagues, the information, so we can be clear, will be available at the end of november, is that correct? >> mid-november. >> mid-november. i'm sorry, mid-november. i have to get it straight for myself. i appreciate that. this is from the same party that attempted to repeal the affordable care act 40 -- over 40 times, you understand, don't you? >> i understand. >> you understand rerepetition is part of the road, the more you ask it, the more you try to repeal things and maybe feel better about it. i wanted you to to be cognizant of that. you mentioned over 700,000 people have completed the application, that that allows them to shop and compare plans with their exact prices and available tax credits. does that show the system is working even with the problems
4:40 am
that you've already started addressing? >> yes, sir, the system is working. we would like for it to work better and we we committed to do that by the end of november. >> the interest in the site, which is -- so impressive in terms of how many people are beginning to take the first steps of the process, to for the first time afford insurance for themselves in this country, is that correct? >> that's correct. >> you are aware that every member on that side of the aisle, republican side of the aisle, to a person is opposed to the affordable care act? >> yes, sir. >> you don't have to answer the question, i'm being rhetorical. do you understand they don't want you to succeed? you don't have to answer that question. they shut down the government of the united states of america in an attempt to repeal the affordable care act. it doesn't pass the lab test
4:41 am
that they somehow care about getting this right or you in your performance of administrator of getting this right and making sure that this health care law is enacted properly. we democrats are looking for problems to fix. the republican colleagues when it comes to this issue, they are looking for problems to exploit. . we cannot a broken website, but we cannot fix broken ideas and broken agenda. that's what he have often to the american people. i'm not asking you to comment. i'm making a rhetorical statement and questions to you. it's very sad, they have nothing to offer, therefore they will attack and tear down. it's much easier to tear down the building than build it up. i appreciate the work you're doing to get this right and make it work for the american people. with that i yield back. >> mr. buchanan and then to mr.
4:42 am
smith. mr. buchanan is recognized. >> thank you, mr. chairman, welcome, madam administrator. last week in florida, i represent part of florida, but obviously looking at florida only member of ways and means, we had 300 people been notified, some cancellations and some adjustments they claim to their fame, that's one carry blue cross, blue shield, probably hundreds and thousands more than that. it seems it's one group in general, not just in florida, but across the country got reported yesterday, i think, which are independent contractors, you might look at the group like realtors for example, self-employed, that they are the most at risk in terms of their insurance or trying to find insurance, they are getting cancellations and then part of that report as you probably know or read, they've known about it for three years, the administration has known about it. are they going to come forward and discuss the concern about the one category, 16 million people, up to 80% at risk that
4:43 am
might lose their insurance? >> i'm not sure what question you're asking. >> people that are independent contractors getting notices from blue cross and blue shield, one of the gentleman mentioned from washington, florida last week, we got $300,000 notice from blue cross, blue shield, it seems it's concentrated on the small business person, someone a sole propriety or or individual contractors? i think the individuals getting the notices tend to be small business or individually insured. but i'm not aware of realtors or any one group. >> you said you lost in the last three years rates have moderated. they've been going up 20, 25% in my district in the last three years on average, got them down somewhat and made some adjustments, the other point i
4:44 am
wanted to mention, i think you said, trying to quote what you said, you thought the system is working. did you say that? you thought the aca is working. >> i think we've seen a lot of improvements from the aca, yes, sir. >> let me tell you, it's a public relations nightmare. i hope you honestly don't feel the system is working. this is just an incredibly bad rollout. there's a lot that needs to be done. i can't imagine how you can think that the system is working. my concern is frankly with such bad experience, so many people going to the site trying to get on and get insurance, why would they want to get involved in a product that might not -- if they had such a bad experience up front, i've been in business 30 years, why would you want to get involved with a company or product that in the next two or three years, you have a concern or issue that you might get the same treatment where you can't get a hold of anybody? >> i think if you talk to individuals who have successfully enrolled, they would tell you they are quite satisfied what they are able to get in terms of pricing and
4:45 am
product. >> 70 to 80% of people have not been able to get through. i don't know how they can feel good about moving forward about health care if they can't get online to do business. >> mr. smith is recognized. >> thank you, mr. chairman and thank you to administrator tavenner for sharing your insight here today. i heard from many citizens about this transition and they are seeing higher premiums and deductibles and higher co-pays and yet we hear you're saying the premiums are going down. could you assure some of these americans that are seeing higher premiums virtually less coverage than they were previously experiencing, could you assure them the premiums would be going down over time? >> i can tell you that compared to cbo estimates, the premiums that actually come in at 18% less than cbo estimates. if you look at large group
4:46 am
insurance, that what we're seeing some of the lowest trends in terms of premium increases, 4 and 5%, i can tell you based on trend, yes, it's coming down. >> i've also heard from some sit zens would went to the website with employer provided coverage for that employee but that employee had a family and he wanted to investigate in terms of whether or not they would qualify in the exchange for the subsidy and was virtually unable to do so? >> what we've encouraged, there are complicated families who will always need assistance. that's why we've encouraged the use of the call center. some folks when they complete the application, they'll have difficult questions. and they are going to need to work with an in-person assistant. that's why the call center exists and it's available 24/7 and a lot of folks are using it. >> the tax credit that suggests it is a remedy for some of the
4:47 am
increased costs through the aca, that accurate? >> i said it's an assistance to those individuals lower income levels -- if you talk to people about why they don't have health insurance, there's two reasons. they can't afford it and they are embarrassed to admit that they don't have it. we're trying to help both. get information out there that it's available to everyone and try to help them with the cost. >> and on the dates you established, mid-november for the numbers of participants reaching coverage through the website and then also november 30th for other problems being rectified, how did you arrive? >> so, in -- we've said all along that we would have information available on enrollment and other metrics after the first month. the first month closes obviously this thursday. we will work with states to put together metrics that will be
4:48 am
available in november. that's something we talked about for months, internal decision the second decision, how we came about identifying the problems in the system and deciding the end of november is sitting down and looking at the problems deciding how long it i would take to add the other issues and that's how we came up with the end of november. it wasn't just us. we also worked with the technical experts as part of the tech surge you read about. >> mr. schwartz is recognized. >> thank you for being here. haven't talked about it too much, but a bit this morning deeply troubling initial rollout supposed to enable all constituent and americans to
4:49 am
access health care coverage in these health care marketplaces. and the fact is and you acknowledge some of this, there rb inexcusable and unacceptable rollout of the launch of this marketplace. as you know, millions of americans and they are in all of our districts are anxious to obtain the information on the options for affordable coverage. with the consumer protections that you pointed out, we saw this interest when millions of americans went online in one day, october 1st, 2013 and the fact is that the administration really failed these americans. they really had -- an experience they should not have had. americans failed to be able to access the information on these options and to be able to enroll the way they expected to and hoped for. the administration has failed to properly test the website, at least that's the way it's been reported. failed to take action to recognize and fix these problems along the way. and you did in the beginning
4:50 am
acknowledge that the initial experience was not a positive one and essentially apologized. i appreciate that and i think so do they. but you also have to acknowledge, the initial experience has done some damage to americans' confidence in website, in the marketplace and even potentially the options they would have available to get health coverage. this is an opportunity to get affordable health coverage but also an obligation under law to make sure this website works because that is the way they are going to find out their options and to be able to enroll. going forward, no more excuses. we need to hear from you there is a path forward and you can be as specific and explicit as you possibly can be with us and with the public to help regain our coverage and the public's
4:51 am
confidence in the ability of the administration and the subcontractors and contractors to get this right. we've heard reports of a lack of coordination in implementing these different contracts. can you speak to -- again, if you can be specific about this? i want to go home and say, this is going to work and it has to work because that is the way americans will access this information and be able to signed up. we all know those people who are under insured uninsured looking for these options. you need to give us some more explicit information how you'll better coordinate the contractors to get this right for the american people. >> that is the information in my opening statement. we at cms have been doing that, cms tends i don't oversee most
4:52 am
programs. because of what i consider the failures in the initial rollout, we felt we need to bring on additional expertise. i'm accountable for this so i think that is one of the big things. the second thing, we've identified two, what i'll call category issues. one had to do with system performance and speed. these were actually people who could complete applications and do the work and the system was just slow. we're an impatient society. we've added capacity and other things to deal with that and persistent performance. i have some metrics there. but on the other side what i'll call the defects like the sticking in the application, where we're actually going through punch lists and we're starting -- i hope you noticed this to do daily tech blogs, daily tech updates with the press to be more transparent about the problems and how we're fixing them so you see -- >> time has expired. you'll have to complement anything further -- >> will be helpful to have that.
4:53 am
>> mr. paulson. >> thank you, thanks for being here. i know you've got a tough job. before october, i think much of the public was looking at the whole debate on capitol hill, many years there will be higher premiums and cancellations would be coming, wouldn't be able to keep your doctor or insurance even though that was laid out in the state of the union speech. this is being confirmed, stories about challenges and own expenses. i look at tricia from bloomington who says her rates are going up 30% in january. these are more expensive, susan aej roger, they like the plan they are on. the rates had been going up previously but now they are going up another 20% and the
4:54 am
insurance company notes that a lot is due to regulations associated with the affordable care act. they looked at plans on the exchange as well and they are more expensive, not the coverage they wants and also have concerns about keeping information private and they don't qualify for subsidies as well. i want to better understand how the administration came up with the november 30th date or deadline. you hired jeff ze ins t, can you tell us more about what the administration did that the exchanges would be ready to go on november 30th, the punch list items to the committee? >> so, yes, i can provide a
4:55 am
punch list and some of the work we're doing. i can give regular updates to the committee. how we came up with the november 30th date, we pulled in a team of external experts to look at the system and look at the problems and say is it fixable and how long does it take. that's the process. you'll see continuous improvement week after week and we can give you the milestones. >> how do you know the schedule will be kept on november 30th? what happens in you miss november 30th? >> i'll remind you in the three years, that the system is working, it's just not working as smoothly or as consistently as we want. so the system is we've been through the hub is working and we were able to correct the create account issue now we're doing most of the fixes to the performance. >> if you can provide a punch list that would be very helpful as we move to the november 30th
4:56 am
deadline. i yield back. >> we've reached out to our constituents to find out what their experiencing trying to comply with the law. these are people that recognizes the law. they are trying to comply and they are frustrated. the first group basically is getting on the website, sometimes takes an hour or sometimes taking several days but finally getting on there and they are finding that they can get care but their premiums are sometimes doubled. the second group is a group that is receiving a cancellation from their insurance company, that prompts them to begin to think about it. they begin to think about complying with the law. these are not rebellious people. these are people that really
4:57 am
sincerely are trying to comply with the law. they are finding out that they can't keep their insurance company. they can't keep their doctor. and they genuinely believe the president when he said they could. these are people that now are very, very frustrated. and they are finding -- they are going through this process and getting -- very angry to begin with. then they are very frustrated and then they get into a very fearful state because they are realizing that they had been told that the website will be up and running by november the 30th. but they are also confusing -- maybe they are confusing the date they must be signed up by december the 15th to have their policy go into effect on january the 1st. and most are them are
4:58 am
experiencing fear they are going to genuinely have a gap in their service, regardless of the prices and the conditions that they are going to have a gap in their service. and i think that's something that you should reelgly be concerned about. that there's going to be a huge gap. the last group i'm hearing from, in texas, we have a worked for years to come up with a high risk group and we have a group of people that are not on medicare, not on medicaid, they are uninsurable and chronic illnesses. and they -- they are very vulnerable. is there some effort being made by your organization to reach out specifically to those state high risk pools and give them some additional assistance and pay close attention to that group because that group in many instances the most vulnerable of
4:59 am
any group in america. >> i'll remind you, this is the group in previous years, before the affordable care act would have had no options and now they are insurable. these are folks that we are reaching out to. we're running the high risk pools in many states but also coordinate that with states running to help them transfer -- >> in my -- >> time has expired. mr. davis. as of october 21st, almost 300,000 unique visitors had go to illinois.gov with 132,334 visitors participating in the plan comparison screener on the
5:00 am
website. over 8,000 people called to get covered call center since its lunch. the medicaid expansion has been a huge success. as evidenced by approximately 100,000 people signing up for county care, prior to the october 1st lunch date. this is a special waiver through which residents of cook county can enroll early and start receiving health coverage in 2013 through cook county facilities. in january, they would be rolled over into the regular medicaid program, another innovative program in illinois was an express enrollment process for s.n.a.p. recipients. in august the state of illinois sent a notice to about 123,0

28 Views

info Stream Only

Uploaded by TV Archive on